摘要
目的观察健脾和降法联合督灸治疗脾胃虚寒型胃癌前病变合并幽门螺旋杆菌(helicobacter pylori,HP)感染患者的临床疗效。方法选择2021年1月—2024年1月到河北省邢台市人民医院就诊的120例脾胃虚寒证型的胃癌前病变患者,按照自愿原则分为健脾和降组和常规组各60例,常规组患者给予保护胃黏膜类药物等常规治疗,伴HP感染者予以三联疗法根治HP;健脾和降组在对常规的基础上予以口服中药“健脾和降”方为治疗,同时外用督灸治疗,疗程均为60 d。观察所有患者的中医病证变化,比较治疗前、后血清胃肠激素含量和HP感染情况变化。结果健脾和降组患者的有效率为95.00%(57/60),明显优于常规组(P<0.05)。经过60 d治疗后,健脾和降组的病理状态和积分水平相较于常规组均明显改善(P<0.01);与常规组比较,健脾和降组患者的痞满、呕吐等症状均明显改善,症状评分水平显著下调(P<0.01);相较于常规组,治疗30 d时健脾和降组患者血清中胃蛋白酶原I(pepsinogen I,PGI)、PGI/PGII以及三叶因子3(trefoil factor 3,TFF3)含量显著增加,而PGII和胃泌素17(gastrin-releasing 17,G-17)含量显著减少(P<0.05,P<0.01),胃动素含量有增加的趋势(P>0.05)。治疗60 d后,健脾和降组患者血清中PGI、PGI/PGII、胃动素以及TFF3含量显著增加,而血清PGII和G-17含量显著减少(P<0.05,P<0.01)。结论健脾和降法联合督灸能够明显减轻脾胃虚寒型癌前病变患者的痞满、呕吐等症状,且无不良反应增加,其作用机制可能与降低胃蛋白酶原、G-17、胃动素以及TFF3等胃肠激素水平相关。
Objective To observe the clinical efficacy of invigorating spleen and harmonizing and descending method combined with Du moxibustion in the treatment of precancerous lesions of deficiency cold of spleen and stomach complicated with Helico⁃bacter pylori(HP)infection.Methods From January 2021 to January 2024,120 patients with precancerous lesions of gastric cancer with deficiency cold of spleen and stomach syndrome who went to Xingtai People's Hospital in Hebei Province were select⁃ed and divided into the invigorating spleen and harmonizing and descending group and the conventional group according to the principle of voluntariness.The patients in the conventional group were treated with conventional drugs to protect gastric mucosa,and those with HP infection were treated with triple therapy to eradicate HP.On the basis of routine treatment,the invigorating spleen and harmonizing and descending group was treated by oral administration of Jianpi Hejiang Formula(健脾和降方),and external application of Du moxibustion.The course of treatment was 60 days.The changes of TCM symptoms of all patients were observed,and the changes of serum gastrointestinal hormone content and HP infection before and after treatment were observed.Results The effective rate of invigorating spleen and harmonizing and descending group was 95.00%(57/60),significantly better than that of the conventional group(P<0.05).After 60 days of treatment,the pathological status and scores of invigorating spleen and harmonizing and descending group were significantly improved(P<0.01).Compared with those of the conventional group,the symptoms of swelling and vomiting in theinvigorating spleen and harmonizing and descending group were significantly improved,and the symptom score was significantly decreased(P<0.01).Compared with those of the conventional group,the contents of pepsinogen I(PGI),PGI/PGII and trefoil factor 3(TFF3)in serum of invigorating spleen and harmonizing and de⁃scending group were significantly increased after 30 days of treatment.The contents of PGII and gastrin-releasing 17(G-17)decreased significantly(P<0.05,P<0.01),and the content of motilin tended to increase(P>0.05).After 60 days of treat⁃ment,the contents of PGI,PGI/PGII,motilin and TFF3 in serum of invigorating spleen and harmonizing and descending group were significantly increased,while the contents of PGII and G-17 in serum were significantly decreased(P<0.05,P<0.01).Conclusion invigorating spleen and harmonizing and descending method combined with Du moxibustion can significantly relieve the symptoms of swelling and vomiting in patients with precancerous lesions of deficiency cold of spleen and stomach,and there is no increase in adverse reactions.The mechanism of action may be related to reducing the levels of gastrointestinal hormones such as pepsinogen,G-17,motilin and TFF3.
作者
杜亚青
李向英
张丽晓
王云芳
韩敏
DU Yaqing;LI Xiangying;ZHANG Lixiao;WANG Yunfang;HAN Min(Xingtai People’s Hospital,Xingtai 054001,Hebei,China)
出处
《中华中医药学刊》
CAS
北大核心
2023年第2期250-254,共5页
Chinese Archives of Traditional Chinese Medicine
基金
河北省医学科学研究重点项目(20191689)。
关键词
健脾和降
督灸
癌前病变
临床疗效
脾胃虚寒型
invigorating spleen and harmonizing and descending method
Du moxibustion
precancerous lesions
clinical effi⁃cacy
deficiency cold of spleen and stomach
